MEDICAL MYSTERY FOR CHAPTER 3: MARY
Mary is a married woman with three grown children. She has just quit
her job as a receptionist because of poor health. For the last few
years, she has found it very difficult to walk up the stairs at work.
She also noticed that her right knee was quite painful and swollen at
times. The daily trip to work on the subway, negotiating the bustling
crowds, was too much for her knee. At home, she noticed that her knee
felt okay when she did not walk much. However, at night she continued to
feel some pain in her right knee and often required pain medications in
order to sleep. She tried several home remedies, including applying
garlic paste, warm compresses, and even Chinese herbs on the knee. As
time went on, she became more disabled. Every time she walked, she felt
that her knee might give out. She tried to use a cane, but the pain was
still unbearable at times. She wanted desperately to lose some weight,
yet she couldn’t really exercise. Her sister told her that she should
try some calcium and vitamin supplements to strengthen her bones.
Mary’s husband finally convinced her to come to my office. She was
always afraid of doctors and had been very reluctant to come. She was
also fearful that she might have rheumatoid arthritis, which had
crippled her best friend Sadie. But she decided that the pain was just
too much and couldn’t put off a visit to the doctor any longer. I
examined Mary and found that her right knee was swollen and painful to
the touch. It also seemed very unstable. I ordered some x-rays and
prescribed pain pills. I gave Mary a referral to an orthopedic surgeon
and suggested that she use a walker in the meantime to prevent a fall.
After reviewing the x-rays of her knee, the orthopedic surgeon told
Mary that she has developed osteoarthritis of the knee. He explained to
her that this was basically a degenerative process and the fluid in
between the joints had completely disappeared. The friction between the
two joints was causing the pain and destroying her joint. She was very
relieved when he told her that her other knee was fine.
The surgeon confirmed that Mary had developed severe degenerative
arthritis of her right knee and recommended total knee arthroplasty as
the best option for her. One month later, she had the surgery, and she
remained in the hospital for 3 days before being discharged to a
rehabilitation center for 3 weeks of physical therapy. She also worked
with a dietitian while in rehab. Mary’s postoperative course was
unremarkable, and she was told that she should continue to watch her
diet. It was also highly recommended that she maintain a regular regimen
of physical activity.
Mary came back into my office 6 months after her surgery and was
walking unaided. She said that the recovery from the knee replacement
had been a slow and sometimes painful process, but that she was now able
to get around well enough to resume working part time. She looked much
happier and healthier than when we first saw her, and she thanked our
staff for making her feel at ease during her first appointment.
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